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Critical analysis of proteinuria estimation methods in pre-eclampsia: A main research article
Authors: Hanumant V. Nipanal, Susmitha Shivanna Reddy, Dilip Kumar Maurrya, Ravindra Pattanashetti Nagendra.
Number of views: 388
Purpose of the study: The gold standard 24-hour urine collection method for protein estimation is inconvenient and is associated with a delay in laboratory analysis. This study was undertaken to analyse the salphosalicylic acid test, urine dip stick test, urine protein to creatinine ratio with 24-hour urine protein estimation in pre-eclampsia cases.
Materials and Method: This is a comparative study and consists of a single group of 240 subjects. This study was conducted in the Department of Obstetrics and Gynecology in collaboration with the Department of Biochemistry, JIPMER, Pondicherry, India, from February 2011 to January 2014. The subjects included 240 pre-eclampsia women. A first voided morning sample was obtained for sulphosalicylic acid test, Dipstick test, urine protein and creatinine estimation, urine culture and Subsequent urine samples were collected for the 24-hour urine protein estimation.
Main findings: For significant proteinuria sulphosalicylic acid test with 1+ proteinuria has sensitivity, specificity, PPV, NPV of 59%,48%,39%,67% where as 2+ has 44%, 88%, 75% and 67% respectively, dipstick test with 1+ proteinuria has sensitivity, specificity, PPV, NPV of 71%, 52%, 54%,70% where as 2+ has 49%, 87%, 75% and 69% respectively. The spot urine protein to creatinine ratio and 24-hour urine protein were significantly correlated (r=0.98; P<0.0001). The cut-off value for the protein to creatinine ratio as an indicator of protein excretion ≥300 mg/day was 0.285. The sensitivity, specificity PPV and NPV were 100%, 99.02%, 100% and 99% respectively.
Conclusion: The spot urine protein to creatinine ratio is a better method for estimation of proteinuria in pre-eclampsia.
Funding: No Funding body, corresponding author himself bear the necessary expenses.